Evaluation of functional outcome of lumbar spondylolisthesis treated with posterior lumbar interbody fusion with instrumentation

K. S. Raja; M. Ravi

doi:10.18203/issn.2455-4510.IntJResOrthop20182736

Authors

K. S. Raja Department of Orthopaedics, Government Dharmapuri Medical College and Hospital, Dharmapuri, Tamil Nadu
M. Ravi Department of Orthopaedics, Government Dharmapuri Medical College and Hospital, Dharmapuri, Tamil Nadu

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20182736

Keywords:

Lumbar spondylolisthesis, Computed tomography, Posterior lumbar interbody fusion

Abstract

Background: Spondylolisthesis with or without spondylolysis occurs in 5% to 8% of the adult population. It is commonly believed that spondylolysis does not exist at birth. The incidence is 4.4% to 5% at the age of 6 years, increasing to 6% at the age of 18 years, which is quite similar to that observed in adulthood.To analyze the functional outcome of posterior stabilization by pedicle screws with decompression and interbody fusion by PLIF (Posterior Lumbar Interbody Fusion) technique in adult single level spondylolisthesis. In this study our aim is to analyze the correlation between the degrees of fusion with functional outcomes.

Methods: This is a prospective study of 20 patients carried out in the Department of Orthopaedics, Govt. Dharmapuri Medical College Hospital, Dharmapuri from January 2016 to December 2017. All patients were evaluated with anteroposterior, lateral and oblique radiographs of the lumbosacral spine. Dynamic plain radiographs of all our patients showed instability. CT/MRI evaluation of all patients was done.

Results: In our study four patients (20%) had a complete reduction of the preoperative slip, fourteen patients (70%) showed a reduction of slip by one grade, while in two patients (10%) there was no change from the preoperative slip percentage.

Conclusions: Further, three dimensional multislice thin section CT scans with multiplanar reconstruction are ideal to study the incorporation of the bone graft within the disc space.

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Author Biography

K. S. Raja, Department of Orthopaedics, Government Dharmapuri Medical College and Hospital, Dharmapuri, Tamil Nadu

assistant professor , annamalaiuniversity, chidambaram

References

Aorta Y, Kumano K, Hirabashi S. Posterior fusion instability at the adjacent segments alter rigid pedicle screw fixation for degenerative lumbar spinal disorders. J Spinal Disorder. 1995;8(6):464-73.

Bassewitz H, Herkowitz H. Lumbar stenosis with spondylolisthesis: current concepts of surgical treatment. Clin Orthop Relat Res. 2001;384:54-60.

Beckers L. Buck’s operation for treatment of spondylolisthesis. 2011: 819–823.

Belfi LM, Ortiz AO, Katz DS. Computed tomography evaluation of spondylolysis and spondylolisthesis in asymptomatic patients. Spine. 2006;31(24):907-10.

Bendo JA, Ong B. Importance of correlating static and dynamic imaging studies in diagnosing degenerative lumbar spondylolisthesis. Am J Orthop. 2001;30(3):247-50.

Berlemann U, Jeszenszky DJ, Buhler DW, Harms J. The role of lumbar lordosis, vertebral end-plate inclination, disc height, and facet orientation in degenerative spondylolisthesis. J Spinal Disord. 1999;12(1):68-73.

Berven S, Tay BB, Colman W, Hu SS. The lumbar zygapophyseal (facet) joints: a role in the pathogenesis of spinal pain syndromes and degenerative spondylolisthesis. Semin Neurol. 2002;22(2):187-96.

Beutler WJ, Fredrickson BE, Murtland A, Sweeney CA, Grant WD, Baker D. The natural history of spondylolysis and spondylolisthesis: 45-year follow-up evaluation. Spine. 2003;28(10):1027-35.

Boachie-Adjei O, Twee D, Rawlins B. Partial lumbosacral kyphosis reduction, decompression, and posterior lumbosacral transfixation in high-grade isthmic spondylolisthesis. Clinical and radiological results in six patients. Spine. 2002;27:161-8.

Boden SD, Riew KD, Yamaguchi K, Branch TP, Schellinger D, Wiesel SW. Orientation of the lumbar facet joints: association with degenerative disc disease. J Bone Joint Surg Am. 1996;78(3):403-11.

Booth KC, Bridwell KH, Eisenberg BA, Baldus CR, Lenke LG. Minimum 5-year results of degenerative spondylolisthesis treated with decompression and instrumented posterior fusion. Spine. 1999;24(16):1721-7.

Buck J. Direct repair of the defect in spondylolisthesis. Preliminary report. J Bone Joint Surg. 1970;52:432–7.

Kimura M. My method of filling the lesion with spongy bone in spondylolysis and spondylolisthesis. Seikei Geka. 1968;19:285-96.

Cloward RB. The treatment of ruptured lumbar intervertebral disc by vertebral body fusion: indications, operative techinique, after care. J Neurosurg. 1953;10;195-202.

Crawford NR, Cagli S, Sonntag VK, Dickman CA. Biomechanics of grade I degenerative lumbar spondylolisthesis. Part 1: in vitro model. J Neurosurg. 2001;9:45-50.

Dai LY, Jia LS, Yuan W, Ni B, Zhu HB. Direct repair of defect in lumbar spondylolysis and mild isthmic spondylolisthesis by bone grafting, with or without facet joint fusion. Eur Spine J. 2001;10(1):78-83.

Davne SH, Myers DL. lumbar spinal fusion with transpedicular instrumentation. Spine. 1992;17:184.

Deguchi M, Rapoff. Biomechanical comparison of spondylolysis fixation techniques. Spine. 2007;24:328–33.

Lauerman WC, Bradford DS, Ogilvie JW, Transfeldt EE. Results of lumbar pseudarthrosis repair. J Spinal Disorder. 2011;5:149–57.

Waddell G, Kummel EG, Lotto WN, Graham JD, Hall H, McCulloch JA. Failed lumbar disc surgery and repeat surgery following industrial injuries. J Bone Joint Surg [Am]. 2012;61:201–7.